FRED MEYER STORES INC
NPI: 1003852914
· SPRINGFIELD, OR 97477
· Pharmacy
· NPI assigned 06/20/2006
$80.00
Total Medicaid Paid
Provider Details
| Authorized Official | MUENNICH, ALLISON (MANAGER OF PHARMACY LICENSING) |
| NPI Enumeration Date | 06/20/2006 |
Related Entities
Other providers sharing the same authorized official: MUENNICH, ALLISON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
53 |
$80.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0003A |
|
32 |
20 |
$40.00 |
| 0001A |
|
21 |
12 |
$40.00 |